Norwich lecture report: don't forget dementia

Eighty people came to hear Dr Sarah Housden from UEA talk on the subject of “Memory, Dementia and the Spiritual Self” at a recent meeting of Science and Faith in Norfolk.

Dementia is a leading cause of disability and dependence among older people and Dr Housden aimed to increase our understanding of the impact of dementia and how spirituality can be important in dealing with it.

One aspect of dementia is often a progressive loss of memory. Dr Housden emphasized the importance of memory, not only for practical living, learning and relationships, but also for our identity. We are who we are because of our memories, which guide our thoughts and decisions, and influence our emotional reactions. Modern neuroscience has helped us to explore some of the connections between mind, body and spirit and suggests some new strategies to support those with dementia.

Dr Housden began by explaining how the cells in our nervous system, the neurones, are involved in forming memories. There are many categories of memory, such as short-term, long term, factual and emotional – and these are based in different regions of the brain. A structure called the hippocampus plays a central role in forming and storing memories in association with several other regions of the brain. For example, the amygdala is a fear-processing centre, involved in creating emotionally charged memories.

Significantly, factual memories are more vulnerable to the effects of dementia than are emotional memories. Dementia can erode the factual memory of an event, but emotional memory of that same event may remain. Thus, someone with dementia may experience strong emotions without knowing what has triggered them. Understanding this may help carers to communicate and deal effectively with those suffering from dementia. The emotional tone of communication may become far more important than its verbal and factual content.

What of spirituality? Dr Housden noted the variety of definitions of this term, which often contrasts material and spiritual things and relates to religious beliefs. She focused on understandings of meaning and purpose in life, for example, how we might answer the question “Why am I here?” It is important to support the spiritual needs of those suffering from dementia and memory loss. Dementia particularly threatens identity, hope, and self-worth.

As well as suffering from the loss of memory associated with dementia, people with can also suffer from their church or faith community forgetting about them, just when they are most in need. Carers need to affirm identity and self-confidence; to provide a sense of security and hope; and to offer warm, loving relationships that provide a sense of value and self-worth.

In our fast-moving society, we often like to discuss recent events and activities, but such topics can highlight the problem of memory loss for people living with dementia. Instead, we need to play to their strengths – for example, by talking about long-term (emotional) memories of events that occurred throughout their whole life-time. We can also provide opportunities for people to participate in familiar activities that draw on well-worn patterns of behaviour. The rituals of church services, like communion, may be a helpful example of this approach.

Such “identity anchors” enable people living with dementia to identify with those around them and to practice their faith. We do not always know what memories will serve as suitable anchors, so we might need to search for themes that get the reaction that we are looking for. Stories are especially important. For example, telling stories about God and what he has done in the past, particularly for us, can offer hope. When people retell the stories of their lives, they are reminded of who they really are, where they came from, and what is truly important. We need to honour a person’s desire to be heard and understood.

“Don’t forget Dementia!” Dr Housden reminded us that it is easy to ignore or forget those with dementia, but the spiritual support of families and friends can provide invaluable benefits. These include easier acceptance of their disease, relief from worrying and anxiety and fewer cases of depression. The church and other faith communities can help people to maintain personal relationships and to increase their happiness and positivity.

Discussion ranged widely. Changes in personality associated with dementia can be disturbing and raise profound questions about how soul and spirit relate to the physical brain. Dr Housden encouraged us to realise that people may start to act out of character because they can no longer suppress the negative urges that we all have, or because they feel constantly frustrated and misunderstood. She urged us to share the infinite love and compassion of God who will not forget us, nor those we care for.

Next event - March 25

The next event organised by Science and Faith in Norfolk will combine bioethics and theology in a talk entitled “Biohacking: - Human gene modification and human dignity”. This will take place on Monday 25th March (7.30 – 8.45 pm) at Trinity Meeting Place, Essex St., Norwich NR2 2BJ. It will be given by Dr Alexander Massmann from Cambridge University, Faculty of Divinity. All are welcome.

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